In humans, a factor associated with response to combination therapy in a large clinical trial is the Thr92Ala polymorphism in the type 2 deiodinase gene (DIO2), wherein the subpopulation of patients with this genetic alteration had improved well-being and preference for combination therapy (7). This has led investigators to consider whether this polymorphism could confer a defect in the D2 pathway, but normal Thr92AlaD2 enzyme kinetics have been demonstrated (73). Only recently has the Thr92AlaD2 protein been found to have a longer half-life, ectopically localize in the Golgi apparatus, and significantly alter the genetic fingerprint in cultured cells and in the temporal pole of the human brain without evidence of reduced thyroid hormone signaling (74). The significance of these studies transcends the thyroid field—this polymorphism has now been associated with a constellation of diseases, including mental retardation, bipolar disorder, and low IQ (75). If hypothyroid carriers of Thr92AlaD2 benefit from alternate therapeutic strategies in replicate studies, then personalized medicine—based on genotype— may have a role.

A discussion on thyroid disease and good health isn’t complete without stressing the importance of physical activity. Lisa Lilienfield, MD, a thyroid disease specialist at the Kaplan Center for Integrative Medicine in McLean, Virginia, and a certified yoga instructor, is a firm believer in the importance of exercise, particularly for clients with a thyroid disorder. “With hypothyroid patients, certainly exercise can help with weight gain, fatigue, and depression. With hyperthyroidism, anxiety and sleep disturbances are so common, and exercise can help regulate both.”


People diagnosed with hypothyroidism are more susceptible to problems with infertility, miscarriages, and having babies born with birth defects. As hypothyroidism progresses it can even lead heart failure, fluid collection in the lungs, and enlarged heart and even a life-threatening condition called myxedema coma. This condition requires immediate medical attention and hospitalization. If you suffer from hypothyroidism and have any of the following symptoms, contact your doctor at the earliest:
Ashwagandha is an adaptogen herb that helps the body respond to stress, keeping hormone levels better in balance. Adaptogens help lower cortisol and balance T4 levels. In fact, in clinical trials, supplementing with Ashwagandha for eight weeks helped hypothyroidism patients significantly increase thyroxine hormone levels, which reduced the severity of the disorder.[1] Also, try other adaptogen herbs like rhodiola, shisandra, ginseng and holy basil that have similar benefits.
People with celiac disease who can’t tolerate the gluten found in many baked goods, pasta and cereals often have Hashimoto’s thyroiditis, and vice versa. Hashimoto’s disease is an autoimmune condition in which your immune system attacks your thyroid. Once rare, Hashimoto’s is now the most common autoimmune disease, according to the May 2017 study in the journal Endocrine Connections.
Correcting these problems requires an integrative approach. It involves more than simply taking a thyroid pill. As you’ll see, it involves nutritional support, exercise, stress reduction, supplements, reducing inflammation, and sometimes eliminating certain foods and detoxification from heavy metals (such as mercury and lead) and petrochemical toxins (such as pesticides and PCBs).
In some areas of the world, iodized salt is an essential way to prevent iodine deficiency, cretinism, and mental retardation due to iodine deficiency in pregnant women. In the United States, however, many people have limited their salt intake or stopped using iodized salt, and you need enough iodine for the thyroid to function properly. An excess of iodine, however, is also linked to increased risk of thyroid disease, so staying in range and avoiding deficiency or excess is essential. 
• Selenium: The highest concentration of selenium is found in the thyroid gland, and it’s been shown to be a necessary component of enzymes integral to thyroid function.14 Selenium is an essential trace mineral and has been shown to have a profound effect on the immune system, cognitive function, fertility in both men and women, and mortality rate.
Most people with hypothyroidism don’t realize that the malfunctioning thyroid gland is usually not the primary cause of their condition. After all, one’s thyroid gland doesn’t just stop producing thyroid hormone on its own, as there is always a cause behind this. So while giving thyroid hormone may do a good job of managing one’s symptoms (although this isn’t always the case), it is not doing anything for the cause of your condition.
Hypothyroidism (low thyroid function) is believed to be one of the most underdiagnosed health conditions in the United States. Many of its symptoms—lethargy, depression and weight gain—can be easily attributed to other factors, making hypothyroidism difficult to diagnose. Some reports estimate that around 15 percent of the population suffers from the condition; other reports estimate more than twice that. Risk increases with age, particularly in menopausal women. Hyperthyroidism (overactive thyroid), the opposite of hypothyroidism, is considerably less common and is characterized by extreme nervousness and restlessness.
A neck lump or nodule is the most common symptom of thyroid cancer. You may feel a lump, notice one side of your neck appears to be different, or your doctor may find it during a routine examination. If the tumor is large, it may cause neck or facial pain, shortness of breath, difficulty swallowing, cough unrelated to a cold, hoarseness or voice change.
The most common treatment I use is Armour thyroid, (9) a prescription drug made from desiccated (dried) porcine thyroid. It contains the full spectrum of thyroid hormones, including T4, T3, and T2 (10). That last one – T2 – is a little-known product of thyroid metabolism that actually may be very important. The right dose ranges from 15 to 180 milligrams, depending on the person.
The foods listed above do not contain any thiocyanate when they are in their living, intact state, because thiocyanates do not form until the plant is cut, crushed, or chewed.   For example, fresh broccoli contains a harmless substance called glucosinolate, which turns into a thiocyanate called sulforaphane when the vegetable is damaged (see my broccoli blogpost for more information).

Chromium picolinate, which is marketed for blood sugar control and weight loss, also impairs the absorption of thyroid medications. If clients decide to take chromium picolinate, they should take it three to four hours apart from thyroid medications.23 Flavonoids in fruits, vegetables, and tea have been shown to have potential cardiovascular benefits. However, high-dose flavonoid supplements may suppress thyroid function.24 The Natural Standards Database provides an extensive list of supplements that have a potential impact on thyroid function, so taking precautions and coordinating patient care with a knowledgeable practitioner is prudent.

Moreover, a strong relationship exists between thyroid disorders, impaired glucose control, and diabetes. Thirty percent of people with type 1 diabetes have ATD, and 12.5% of those with type 2 diabetes have thyroid disease compared with a 6.6% prevalence of thyroid disease in the general public. Both hypothyroidism and hyperthyroidism affect carbohydrate metabolism and have a profound effect on glucose control, making close coordination with an endocrinologist vital.8


In the past, doctors weren't able to detect hypothyroidism until symptoms were fairly advanced. But by using the sensitive TSH test, doctors are able to diagnose thyroid disorders much earlier — often before you experience symptoms. Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a thyroid hormone test if needed. TSH tests also play an important role in managing hypothyroidism. They help your doctor determine the right dosage of medication, both initially and over time.
Going “natural” is an evolving trend in healthcare. Even hypothyroid patients are exploring their options outside of synthetic thyroid hormone. One such option is a so-called natural thyroid supplement made from dried animal thyroid glands. These are usually derived from pigs (called Armour Thyroid) but are also sometimes made from dried cow thyroids. (3)

Heart problems - Hypothyroidism may be associated with increased risk of heart disease, mainly because high levels of low-density lipoprotein cholesterol (“bad” cholesterol) may occur in patients that have an underactive thyroid. Even mild or early stage hypothyroidism that does not present symptoms can cause an increase in total cholesterol levels and diminish the heart’s ability to pump blood.

People with celiac disease who can’t tolerate the gluten found in many baked goods, pasta and cereals often have Hashimoto’s thyroiditis, and vice versa. Hashimoto’s disease is an autoimmune condition in which your immune system attacks your thyroid. Once rare, Hashimoto’s is now the most common autoimmune disease, according to the May 2017 study in the journal Endocrine Connections.
Making dietary changes is your first line of defense in treating hypothyroidism. Many people with hypothyroidism experience crippling fatigue and brain fog, which prompts reaching for non-nutritional forms of energy like sugar and caffeine. I’ve dubbed these rascals the terrible twosome, as they can burn out your thyroid (and destabilize blood sugar).
“Infants fed soy formula are at higher risk for hypothyroidism and for later development of autoimmune thyroid diseases. In humans, goiter has been seen in infants fed soy formula; this is usually reversed by changing to cow milk or iodine-supplemented diets . After the 1960s, manufacturers reportedly began adding iodine to formulas to mitigate thyroid effects.” [Doerge]
From the early 1890s through the mid-1970s, desiccated thyroid was the preferred form of therapy for hypothyroidism (Appendix Table, available at www.annals.org). This preference was reinforced by the unique ability of desiccated thyroid to reproduce a normal serum PBI (33). The predominance of natural thyroid products was illustrated by prescribing patterns in the United States: In 1965, approximately 4 of every 5 prescriptions for thyroid hormone were for natural thyroid preparations (38). Concerns about inconsistencies in the potency of these tablets arose (26) after the discovery that some contained anywhere from double to no detectable metabolic activity (39). The shelf-life of desiccated tablets was limited, especially if the tablets were kept in humid conditions (36). There were reports of patients not responding to desiccated thyroid altogether because their tablets contained no active thyroid hormone. It was not until 1985 that the revision of the U.S. Pharmacopeia standard from iodine content to T3/thyroxine (T4) content resulted in stable potency (38), but by then the reputation of natural thyroid products was tarnished (40).
Taking synthetic thyroid hormone can make up the difference and make you feel more like yourself. But eating certain foods—and limiting your consumption of others—can also help your thyroid function at its best, explains Hong Lee, MD, a double board-certified internist and endocrinologist with AMITA Health Adventist Medical Center Hinsdale in Illinois. That could allow you to avoid having to take higher and higher doses of synthetic thyroid hormones, and eventually end up relying on them completely in order for your thyroid to function.
People with celiac disease—the autoimmune disease that's characterized by an intolerance to the gluten in wheat, barley, and rye—are also more likely to have higher rates of thyroid problems, according to a 2007 report by researchers in the United Kingdom. "Eating a gluten-free diet helps control the symptoms, which may also help protect the thyroid gland," says Ilic. But unless you have celiac disease—and we're not talking an L.A.-aversion to gluten, here — you might not want to avoid breads after all. In fact, thanks to some of the baking processes, bread can actually contain some iodine.

Most patients report improvement with a thyroid supplement too, but if you consistently eat a healthy and wholesome diet they are unnecessary. If you still want to try one however (under the supervision of your doctor), see this Thyroid Support Supplement (disclosure: this is an affiliate link). It contains both selenium and iodine for thyroid health, as well as vitamin B12 for improved energy levels. Additionally, it is one of the few available that is 100% vegetarian.
Hyperthyroidism, or overactive thyroid gland, is another common thyroid condition. The most prevalent form is Graves’ disease in which the body’s autoimmune response causes the thyroid gland to produce too much T3 and T4. Symptoms of hyperthyroidism can include weight loss, high blood pressure, diarrhea, and a rapid heartbeat. Graves’ disease also disproportionately affects women and typically presents before the age of 40.4

In summary, I do NOT believe that we need to cut these wonderful vegetables out. Just don’t juice them and don’t eat them excessively in a raw form. Their nutritional profile is so high that we are doing ourselves a dis-service by cutting them out, only to load up on supplements instead. Most people who suffer from hypothyroidism have Hashimoto’s disease – you need to take care of your gastrointestinal health as your #1 priority, followed by stable sugar levels (see above) and lastly, by supporting your liver function (listen to our free Workshop on thyroid and liver connection).


If you suffer from hypothyroidism, you should not eat them raw. Goiter is a substance that inhibits iodine uptake to create the T4 hormone. The family of crucifers are: bok choy, broccoli, Brussels’ sprouts, cabbage, cauliflower, kale, mustard greens, radishes, soy, soy milk, soy lecithin (often used as a filler in vegetarian food) and tofu. Cooking them reduces their goitrous properties, however, so they can still be an important part of a diet for thyroid health.
Most patients report improvement with a thyroid supplement too, but if you consistently eat a healthy and wholesome diet they are unnecessary. If you still want to try one however (under the supervision of your doctor), see this Thyroid Support Supplement (disclosure: this is an affiliate link). It contains both selenium and iodine for thyroid health, as well as vitamin B12 for improved energy levels. Additionally, it is one of the few available that is 100% vegetarian.
Like many progressive thyroid practitioners, such as Dr K and Dr Wentz, I believe there is no need to cut these wonderful vegetables 100% out of our diets. The reason is: all crucifers are high in DIM (di-indolyl-methane) which is a substance that supports the liver detoxification pathways. This detoxification process helps us eliminate metabolized (or “used up”) hormones like estrogen as well as thyroid hormones to make space for new ones.

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Please Note: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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